Hi nattysmom, I have so much respect for you and the other parents of Type 1 children. I was diagnosed Type 1 at the age of 27 so didn't have to deal with diabetes as a young child. I think you're doing an awesome job and your daughter is so lucky to have you to guide and support her. I think her A1c is great for a child!
I agree with those who say that you should keep doing what you're doing. It's all about balance with kids I believe. After 25 years with diabetes, I think it's important for parents of children to remember that it's a marathon not a sprint. If you severely restrict your daughter's food at a young age to the point where she feels deprived, I believe you're more likely to see her rebel with food choice as a teenager or young adult.
My sister-in-law would not allow her (non-diabetic) kids to eat sweets growing up, they only ate organic and very healthy at home...but when those kids were away from home, I saw them dive into a plate of cookies with both hands and mouths stuffed.
While I personally low carb as an adult because that's the only way I can get stability these days, I did not always. In my younger years it was much more predictable for me and I could handle eating more carbs while still getting decent numbers.
Now answer me this: if you are eating very low carbs are you eating more protien? or more fats? cause with to much protien I would then start worrying about the weight issues.... give me some ideas about low carbs and what else in place to you guys eat?
A few thoughts (trying not to reiterate what others have said):
I think your flexible approach is good. It's very common for people diagnosed with T1 as children to develop "food issues" because of the intense focus on food. By not making a big deal of things if she wants more, you are setting her up for healthy eating habits as she gets older.
That said, help her understand the impact of certain foods on her BG. It's ok for her to have a treat now and again, but "treats" (i.e., things that make her BGs wacky) should not be a regular occurrence. If you do this, she will hopefully learn to correlate feeling better with better food choices.
Make sure to have lots of low-carb snack items handy, as well as other "safe" foods. There may be some foods that have lots of carbs in them, but are safe for her to eat regularly in moderation. For me, fruit and non-fat frozen yogurt are two such foods - they have lots of carbs BUT they cause a very predictable rise and fall of my BG. I can easily bolus for them and usually wind up within range. Help her make low-carb choices whenever possible, as this will decrease the fluctuations in BG levels.
An A1C of 6.7 is awesome!! Even the low 7s would not be bad (IMO). Keep in mind that children tolerate slightly higher BGs better than adults do. At her age, persistent lows could interfere with brain development. And you also don't want her developing hypo unawareness.
Does your daughter use exercise at all to help control her BGs? When I was a kid, treats or food excursions were used as rewards for intensive exercise. It was the one time I knew I could eat something without my BG going haywire! Phil Southerland writes about this in his book as well. It was a common management tool back in the day, one that we have unfortunately moved away from.
Do you know what foods are most problematic for your daughter? For me, my "problem" foods are white flour, bread, pasta, and rice. Because these foods cause me so much trouble, I really try to stay away from them as much as possible. To the extent you can, help your daughter identify her "problem foods" and encourage her to make choices that don't involve these foods whenever possible. Again, this doesn't have to be absolute. I will eat rice from time to time, but I do so rarely and I know when I do, I'm going to possibly be in for a long night.
With T1, it's hard to balance everything - keep the A1c but don't become so rigid with food that you create emotional issues. You want her to have a normal childhood but the obsession over preventing complications can stand in the way of creating a "normal" environment. It's all a balancing act and it sounds like you're doing a really good job.
I’m not eating “very” low but maybe 90-100/ day, a bit less than rx’ed for me. I’ve replaced a lot of carbs w/ stuff like eggs for breakfast, carrots (which have carbs…), lower carb bread, etc. I think carbs are more likely to cause weight issues than protien, or at least they did in my case? As I’ve reduced carbs, I’ve lost weight. I plateau and cut out some more and lose a bit more. I’ve gone very slowly at it. I’m not sure my own kid would be a huge fan of that sort of plan either but we all enjoyed burgers w/ low carb buns and veggies instead of fries the other night and were ok.
I just checked my pump to see how many carbs I eat in a day, man it is a lot, but I believe what I have learned and why I think I am low carbing, is that I avoid carbs that I know will result in a definite high (and a long lasting high.)
Autonomy is important for many reasons. Before you know it, she is going to be staying away from home for stretches of time, whether she's staying after school for activities or hanging with friends. You need to make sure that she knows how to handle her diabetes in those settings without your guidance. At her age, she should definitely be operating the pump herself (under your supervision). Also, things happen and (I think) as a parent it would be reassuring to know that if you were separated from her for any reason (i.e., she got lost in a mall or you were hospitalized for a period of time) that she could take care of herself.
yes she know hows to give herself boluses, she knows how to get info from the pump!! but she doesnt know how to change her pump, nor does anyone else in my household know... whick i know needs to change, and soon enough she will be able to change it hersef!! I do take alot of the responsiblity and I think thats the control freak in me.... but I know I have to make some changes!! but right now in my household theirs alot going on... So as soon as evertyhing stablaizes assuming it does I will need to teach others how to change her pump!!!!!!
I dunno if A1C is the "target" as much as the result of all the other targets added together and adjusted for the vagaries of the data reporting. I agree the overall BG goal should be sort of conservative. One way to smooth out the curves and reduce the margins of inevitable errors would be to cut out some of the carbs?
If your ratio were 10G/U and you eat 60G of carbs, the chances of the food being exactly 60 are sort of slim, as there might be a big piece of meat (+3G) or a bubble in the bread (-2G) or junior might peel the crust off (my kid does this @ 13, it drives me nuts, I save it for some other battle...), maybe -5G? I think a little bit off can really give the insulin some "teeth" and drive it down or help the carbs blow up an afternoon number. By eating a few less carbs, maybe 45G of carbs, not exactly "starving" (inevitable kid complaint...), the there's only 4.5U of insulin so there's not as many teeth to "bite", as it were?
Aimee: wow about the paramedics, we have not had that at school luckily... and she has been as low as a 29 while at school and she was ok, she was pale and shaky but awake and talking!!! she seemed fine, dont know for how long she would have stayed fine! is your daughter newly DX? my daughter started realizing her lows really early on, some dont though, my daughter as well has dropped quickly too, sometimes even if she has been very active in a day it will linger all day and sometimes into the next day, and make her #s low. Im having a hard time going back to work, I just coincedently was laid off 4 months before she was hospitalized, and now its getting to the end of my unemployment and I need to go back to work, I have been looking but no luck! Im not sure how I can with her Diabetes,And most daycares are not qualified to have a type1 in there daycare. now do i want someone elses maintaining it... I need it maintained like I would so later on she dont have problems due to the lack of care. eventually she will be able to all of it but for now she dont. do you feel the same about working? well anyways good luck to you!
